Abstract
BackgroundPrevious cohort studies investigating the association between sarcopenic obesity (SO) and all-cause mortality among adult people have been inconsistent. We performed a meta-analysis to determine if SO is a predictor of all-cause mortality.MethodsProspective cohort studies that evaluated the association between SO and mortality in older people were identified via a systematic search of three electronic databases (PubMed, EMBASE, and the Cochrane Library). A random-effects model was applied to combine the results. We considered the methods recommeded by consensuses (dual X-ray absorptiometry,bio-impedancemetry, anthropometric measures or CT scan) to assess sarcopenic obesity.ResultsOf the 603 studies identified through the systematic review, 23 (Participants: 50866) were included in the meta-analysis. The mean age ranged from 50 to 82.5 years.SO was significantly associated with a higher risk of all-cause mortality among adult people (pooled HR = 1.21, 95% confidence interval [95% CI] = 1.10–1.32, p < 0.001, I2 = 64.3%). Furthermore, the subgroup analysis of participants showed that SO was associated with all-cause mortality (pooled HR = 1.14, 95% CI: 1.06–1.23) among community-dwelling adult people; similarly, this association was found in hospitalized patients (pooled HR = 1.65, 95% CI: 1.17–2.33). Moreover, the subgroup analysis demonstrated that SO was associated with all-cause mortality when using skeletal muscle mass (SMM) criteria, muscle strength criteria, and skeletal muscle index (SMI) criteria (HR = 1.12, 95% CI: 1.01–1.23; HR = 1.18, 95% CI: 1.05–1.33; and HR = 1.53, 95% CI: 1.13–2.07, respectively). In addition, we analyzed SO on the basis of obesity definition and demonstrated that participants with a SO diagnosis based on waist circumference (WC) (HR = 1.24, 95% CI: 1.09–1.40), body mass index (BMI) (HR = 1.29, 95% CI: 1.04–1.59), or visceral fat area (HR = 2.54, 95% CI: 1.83–3.53) have a significantly increase mortality risk compared with those without SO.ConclusionBased on our update of existing scientific researches, SO is a significant predictor of all-cause mortality among older people, particularly hospitalized patients. Therefore, it is important to diagnose SO and to treat the condition to reduce mortality rates among older people.
Highlights
Previous cohort studies investigating the association between sarcopenic obesity (SO) and all-cause mortality among adult people have been inconsistent
We found the sensitivity analysis of age group showed that Participants age 50–70 years with SO was associated with all-cause mortality; participants with SO aged 70 years and older did have a marginally association (Additional file 5: Figure S4)
Our study found that people with SO significantly increase the risk of mortality with a 1.21-fold risk comparing to non-sarcopenic non-obese
Summary
Previous cohort studies investigating the association between sarcopenic obesity (SO) and all-cause mortality among adult people have been inconsistent. Sarcopenia is defined as a condition of age-related loss of muscle mass and muscle strength with functional impairment in terms of physical performance, and it has been associated with a series of adverse health consequences among older adults [1], including falls [1] and fractures [2], decreased mobility [3], depression [4], poor quality of life [5], hospitalization [6], and mortality [7]. The prevalence of obesity in the adult people of the world is rising alarmingly [8], potentially augmenting supplemental conditions and increasing the risk of adverse health outcomes. Given the fact that both sarcopenia and obesity would increase the risk of all-cause mortality [13, 14], it is hypothesized that the coexistence of sarcopenia and obesity may synergistically aggravate the risk of mortality
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